PACS in Scotland Dr Andrew Downie Consultant Radiologist Victoria Infirmary, Glasgow.

PACS in Scotland

Dr Andrew DownieConsultant Radiologist

Victoria Infirmary, Glasgow

Scotland is different• Devolution 1999• Abolition of NHS

Trusts• Run by 14 Health

Boards• CfH does not apply

The PACS Contract

• Main Contract

– Kodak & NHS National Services Scotland – Nov

2005

• Archive Storage

– ATOS Origin Change Control Note – Dec 2005

• Health Board Access Agreements

– Kodak & NHS Greater Glasgow – April 2006

“A major project”

– “A multi-dollar project…”

– “Kodak will roll out PACS to all hospitals in Scotland over the next 25 years…”

• RAD Magazine announced the contract to the world:

What is included?

• 39 main acute hospitals• 67 satellite centres• 3.2 million exams annually• 2 central data archives• 308 dual 3mp workstations, RIS integrated• Web browser access• Orthopaedic templating on web

And what isn’t?• The Network• The RIS• Ward & Clinic PCs• Theatre & specialist workstations• Mammography• VR (separate procurement)

Who pays?

Central funding• All capital elements

– Workstations, hardware, training– Central archive– Software licences– Implementation charges– Software support & upgrades for 10

years– One hardware refresh in 10 years

Local funding– Hardware support charges– Capital charges– Additional catalogue items– Local PACS System Manager(s)– Project Management costs

Storage Policy• 1 year on site• “Store everything for ever”• Until death plus 3 years• Use of lossy compression after 3 years• Review after 6 years• Funded for baseline plus 5% growth pa

Patient ID• DICOM ID = RIS ID locally• DICOM ID = CHI number nationally• CHI = Scottish NHS number, 10 digit• “No CHI, you’re not getting in”• Dirty store• Kodak / RIS / PAS / SCI Store interface

Problems• CHI availability• SCI Store problems• Multiple RIS• Image & report viewing• Legacy PACS

Differences: England & Scotland• Based on English OBS, but• No LSP• Direct relationship with Kodak• Clinical engagement• No single RIS• Integration with RIS included• Spine supplied by Scottish Exec – SCI

Store

RIS Procurement• Varied RIS in Scotland• Many new RIS for Y2K compliance• No standard RIS for this project

but• National RIS procurement now in progress

for future RIS needs

EPR Procurement• Scottish Executive committed to EPR• No actual progress to date

CR Procurement• National contract• Central funding for pre agreed needs• Additional hardware at favourable prices• Awarded to Fuji• Installations timed to match PACS

The future is bright?• April 2006

– PACS– Voice Recognition– and…